Don’t let genie out of the bag

Robert J. Petrella, As You Were Saying ...Sunday, October 06, 2013

My political leanings are libertarian. On most days, I bemoan our society’s slide toward the nanny state and the continual erosion of our individual liberties, privacy, and personal autonomy. But on the issue of drug legalization, I stand firmly with the advocates of tough anti-drug laws, and I was upset by the recent Department of Justice decision allowing states to decriminalize marijuana use.

Here’s why:

Marijuana can be addictive. The National Institute on Drug Abuse cites the following statistics: about 9 percent of people who smoke marijuana become dependent on it; this includes about 16 percent of those who start smoking it in their teens, and up to 50 percent of those who smoke daily. Organizations like Marijuana Anonymous exist to support addicts and their families.

It impairs thinking. Cigarette smoking has many short and long-term health effects, but it doesn’t cause immediate changes in cognitive function, at least not to the level that affects performance. Clearly, marijuana does. If everyday experience isn’t convincing enough, multiple studies have detailed this. In addition, a growing body of evidence indicates that heavy marijuana users may suffer longer-term cognitive effects. The counter-argument to this is that alcohol also impairs thinking, yet is legal. That is true, but it’s akin to arguing that you should be allowed to shoot your spouse because your neighbor did it and got away with it.

It is long-acting. Unlike alcohol, which is eliminated from a person’s system in a matter of hours, the active ingredient in marijuana, THC, is fat-soluble, which means that it and some of its metabolites can accumulate in body tissues over time. THC is detectable in the blood of habitual marijuana smokers for over a week after last use and can reside in tissues for weeks or months.

Its use has many other documented health effects, including increased risks for anxiety and panic reactions, motor vehicle accidents, respiratory infections, and, in young users, schizophrenia. Marijuana smoke contains many of the same carcinogens as tobacco smoke, and some studies, not surprisingly, have shown a link to lung cancer.

Its use is related to use of other drugs. Whether marijuana is a “gateway” — i.e., whether its use causes people to use other drugs — is disputed, but what’s clear is that disproportionately many people who smoke marijuana do use other drugs as well.

Legalization would send the wrong signal, especially to young people. Laws serve not only as limits to behavior, but also as a reflection of what behaviors society encourages, or at least approves of. Legalizing marijuana would be construed as a societal endorsement of the drug’s use.

Regulation is no panacea. OxyContin, Vicodin, Xanax, and Adderall, to name a few examples, are all “tightly” regulated prescription drugs whose abuse is widespread.

Many people consider marijuana harmless. The average young person is far more aware of marijuana’s illegality than its ill psychological and physical effects. But better education on drugs doesn’t depend on their legal status. We need to better educate people about them, period.

In the meantime, government approval and greater availability of recreational drugs for a population that remains largely uninformed about their hazards — particularly the young — is a recipe for increased use.

And, with all due respect to the principles of individual liberty and personal autonomy, that’s not good for any of us.

Dr. Robert J. Petrella is an emergency physician and research scientist in Boston.